Symbicort

Symbicort is a long-acting inhaler used to treat people with chronic airway problems, including asthma and COPD. A recent study has suggested that COPD patients who begin treatment with medications like Symbicort face a heightened risk of cardiovascular problems within the first 30 days of treatment.

What is Symbicort?

Symbicort belongs to a class of bronchodilators called inhaled long-acting β2-agonists (LABAs). The medication is currently approved for:

Maintenance treatment of asthma in patients 12 years or older whose asthma is severe or not well-controlled with other long-acting asthma medications.

Maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and emphysema.

Maintenance treatment of asthma in pediatric patients aged 6 to 12 years.

Reducing exacerbations of COPD.

Symbicort is a maintenance inhaler that is intended to be used daily (2 puffs per day, twice a day). Symbicort should never be used to treat an asthma attack that has already begun, as it will not work fast enough. Asthma attacks should only be treated with fast-acting rescue inhalers.

How Does Symbicort Work?

Symbicort contains two active ingredients, budesonide (an inhaled corticosteroid) and formoterol fumarate dihydrate (a LABA). Budesonide helps to reduce the amount of swelling in the airways, allowing more air to pass through the lungs.

LABAs like formoterol work by relaxing the muscles that surround the airways, thus helping to prevent bronchospasms.

Symbicort and Heart Problems

A study published in the January 2018 issue of JAMA Internal Medicine suggested that COPD patients who initiate new treatment with Symbicort and other long-acting asthma inhalers may be at a heightened risk for serious heart problems during the first 30 days of treatment.

The study, which was conducted by a team of researchers in Taiwan, involved more than 280,000 COPD patients who were prescribed either an LABA, like Symbicort, or a long-acting antimuscarinic antagonists (LAMA) from 2007 to 2011. The study authors reviewed their medical records in order to compare hospital visits for coronary artery disease, heart failure, ischemic stroke or arrhythmia against the duration since initiation of long-acting inhaler therapy.

The analysis indicated that patients who used either type of long-acting inhaler were 50% more likely to experience cardiovascular problems like a heart attack or stroke within the first 30 days of initiating treatment.

While the risk declined over time, the researchers suggested that doctors screen COPD patients for heart problems prior to initiating treatment with a long-acting inhaler. Patients who begin new treatment with a LABA or LAMA should seek medical attention for symptoms that might indicate a heart problem, such as chest pains or a suddenly rapid heart beat.

Patients should also undergo a follow-up exam after treatment has begun to ensure they’re not experiencing symptoms associated with cardiovascular disease, the study authors said.